Pediatric Amblyopia (lazy eye)

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Every year hundreds of children are evaluated and treated at Children’s National for amblyopia ("lazy eye") and its underlying causes. Children's National pediatric ophthalmologists have extensive experience in identifying and treating the condition, which affects 4 to 5 percent of the population.

Amblyopia is almost always treatable if detected early. With increased awareness, early vision screening and referral, and timely diagnosis and management of amblyopia, proper visual acuity can be restored. Drawing on their wide experience, Children's National pediatric ophthalmologists will design an individualized treatment plan for each child.

What is ambylopia?

Ambylopia, often called "lazy eye" is poor sight in a normal eye. During early childhood, a child's brain actively develops its visual pathways from the eyes to the visual processing center. This process occurs from the first month of life until around 8 to 10 years of age, after which the pathways are permanently set. If development of the visual pathways is impeded, the affected eye may never develop good vision.

Some of the most common causes of ambylopia include various forms of strabismus (misalignment of the eyes), uncorrected refractive errors, newborn cataracts, or ptosis ("droopy eyelid").

What are the symptoms of amblyopia?

There may be no symptoms. Because vision problems from amblyopia affect only one eye, the child may function with one good eye and be unaware of the problem. Early detection is important.

How is amblyopia diagnosed?

A visual acuity test is an important screening tool. These tests are performed at schools, health fairs, and primary care clinics, usually beginning around 3 or 4 years of age. If there are concerns regarding visual acuity, a full eye exam is needed.

What is included in the treatment of amblyopia?

Treatment of ambylopia at Children's National is designed to both address the underlying cause and help the brain use the eye that has been effectively ignored. Based on their extensive experience, Children's pediatric ophthalmologists will carefully individualize each child's treatment timeline and regimen, taking into account what is most suitable for the condition, the child's age and temperament, and the family's dynamics.

Treating the underlying cause of ambylopia may involve:

Glasses

Surgery

Patching

Patching

Treatment of amblyopia may involve the use of patching or atropine drops in the good eye to encourage the brain to use the affected eye more, making its visual development stronger.

Patching can be a challenge for any parent and child. Most children with amblyopia are too young to appreciate the benefits of patching and it can be an annoyance. Adhesive patches, available at most pharmacies, are the gold standard for treatment.

Some patients may be able to use atropine eye drops instead, depending on the type and severity of their amblyopia. There are rare occasions when felt patches also can be used. A Children’s National specialist will be able to tell you which options are appropriate for your child, based on a thorough evaluation.

What is the long-term outlook for a child with amblyopia?

The good news about amblyopia is that it can be a very treatable disease, leading to improved vision, if effectively addressed in a timely manner. Treatment may be needed throughout childhood to best treat the child and timely follow-up is of crucial importance. Follow-up appointment intervals may range from a few weeks to a few months, depending on the age of the child, type of amblyopia, and severity of the disease.